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NPI Code Detail

MEDICARE: BETHANY YOUNG OTR

MEDICARE: BETHANY YOUNG OTR
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist17-03112KS

General Provider Information

NPI Number : 1689041683
Entity Type Code : Individual
Provider Name (Legal Business Name) : BETHANY YOUNG OTR
Provider Business Mailing Address
First Line : 3066 N KENTUCKY ST
Second Line :
City : IOLA
State : KS
Zip : 66749-1951
Country : US
Telephone Number : 620-365-1000
Fax Number :
Provider Business Practice Location Address
First Line : 3066 N KENTUCKY ST
Second Line :
City : IOLA
State : KS
Zip : 66749-1951
Country : US
Telephone Number : 620-365-1000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/25/2015
Last Update Date : 08/25/2015

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